Clinical characteristics and prodrome of Vasovagal syncope(vvs) in young and old.
|
|
- Holly Allison
- 8 years ago
- Views:
Transcription
1 Clinical characteristics and prodrome of Vasovagal syncope(vvs) in young and old. Clodagh O Dwyer, Ciara rice, Dymphna Hade, Lisa Byrne, Michelle Burke, CW Fan, RA Kenny Falls & Blackout Unit, St. James Hospital
2 Syncope C O'Dwyer - BGS Aut 2009 Cardiac arrhythmia Structural Heart disease Cerebrovascular Psychogenic Orthostatic Neurally Mediated Carotid sinus Syncope Vasovagal Syncope
3 Vasovagal Syncope (VVS) C O'Dwyer - BGS Aut 2009 Definition 40% one episode per lifetime benign Murdoch BD. S AfrMed J 1980;57: Ganzeboom et al, Am J card 2003;91: Age of onset Sheldon et al, J Card Elect 2006;17:49 54 Colman et al, Clin Auton Res 2004;14 suppl 1: % of recurrent syncope older adults Wieling et al, Mayo Clin proc 2003;78: Colman et al, Clin Auton Res 2004;14: suppl 1:9 17 Vasovagal syncope vs Vasovagal disease Brignole M. Hellenic J cardiol 2008;49:61 64
4 Proposed Mechanism: VVS
5 Prodrome Lightheadedness Palpitations Sweating Warm feeling Nausea/vomiting Blurred vision Dark vision Headache Hearing disturbance Rising stomach feeling Paraesthesia/tingling Pain neck/shoulder/a/l Yawning Giddy sensation
6 Triggers for VVS Standing Church Shopping Crowded environment Heat Exercise Postprandial Situational Coughing Micturition Defecation Medical settings Emotional stress
7 Diagnostic dilemmas in older adults Short prodrome Prodrome recall Guida et al. Europace july 2009 Amnesia for loss of consciousness (falls presentation) Parry et al. Can J cardiol 2002; 18(7): Kenny et al. JACC 2005; 45 (11): Higher tolerance to Head up tilt table (HUTT) testing Sheldon R. Am J Cardiol 1994;74(5):459 63
8 Aim To define clinical characteristics of VVS in older persons in comparison to that of younger: 1. Prodromal symptoms 2. Trigger factors 3. Amnesia for loss of consciousness
9 Methods 1 Recruitment Falls & Blackout Unit Consecutive new referrals with unexplained falls/syncope over a nine month period completed a 74 item Structured Questionnaire Cross checked for completion with clinical data ESC guidelines followed Head up tilt table(hutt) where indicated(mmse>26)
10 Methods 2 Type 3 Vasodepressor Type 1 Mixed Type 2 A Cardioinhibitory Type 2 B Cardioihibitory BP drop only BP drop with < 40bpm for < 10 sec +asystole < 3 sec BP drop with > 40 bpm for > 10 sec + asystole > 3 sec < 40 bpm for > 10 sec + asystole > 3 sec prior to or at time of BP drop QuickTime and a YUV420 codec decompressor are needed to see this picture. Loss of consciousness witnessed by supervising doctor and clinical nurse specialist Patients questioned on their recollection of LOC immediately post tilt back and prior to leaving the clinic.
11 Results: Pathway of Investigation Questionnaire (n=400) History & Examination ECG & Active Stand Diagnosis Cardiac Neuro CSM HUT(n=163) VVS Neg (n=69) VVS Pos (n=94)
12 Results: End diagnosis VVS (n=94) < 60 years > 60 years Number N=59 N=35 Mean age years years Female N=39 (66.1%) N=24 (68.6%) Male N=20 (33.9%) N=11 (31.4%) Unexplained falls N=24 (40.7%) N=15 (42.9%) Fractures due to falls or syncope N=6 (10.2%) N=8 (22.9%)
13 Age of onset of syncope (n=83) Age range
14 Warning symptoms(n=94) <60yrs(n=59) > 60yrs(n=35) P value OR(95%CI) Sweating 30 (50.8%) 11 (31.4%) [0.94,5.43] Lightheaded 47 (79.9%) 19 (54.3%) [1.31,8.26] Palpitations 20 (33.9%) 5 (14.3%) [1.04,9.17] Feeling Warm 31 (52.5%) 11 (31.4%) [1.00,5.81] Chest pain 8 (13.6%) 0 (0%) 0.02 Hearing dist. 9 (15.3%) 1 (2.9%) [0.74,50] Tingling 13 (22%) 3 (8.6%) [0.79,11.5]
15 Warning symptoms (n=94) Symptom Age < 60(n=59) Age > 60(n=35) P value OR[95%CI] Nausea 18 (30.5%) 14 (40%) [0.28,1.58] Vomiting 5 (8.5%) 2 (5.7%) [0.28,8.33] Feel Giddy 5 (8.5%) 5 (14.3%) [0.15,2.07] Funny stomach sensation 11 (18.6%) 11 (31.4%) [0.18,1.32] Yawning 0 (0%) 2 (5.7%) 0.06 Headache 10 (16.9%) 3 (6.8%) [0.56,8.55] Blurred vision 21 (35.6%) 8 (22.9%) [0.72,4.83] Dark Vision 19 (32.2%) 11 (31.4%) [0.42,2.54] Arm/Leg pain 6 (10.2%) 2 (5.7%) [0.36,9.8] Neck/shoulder pain 5 (8.5%) 2 (5.7%) [0.28,8.33] Short of breath 13 (22%) 4 (11.4%) [0.65,7.35]
16 Triggers for VVS < 60 yrs(n=59) > 60 yrs(n=35) P value OR[95%CI] Standing 27 (45.8%) 17 (48.6%) [0.39,2.07] Postprandial 4 (6.8%) 4 (11.4%) [0.13,2.41] Venepuncture/ sight of Blood 8 (13.6%) 0 (0%) Post exercise 6 (10.2%) 0 (0%) 0.05 Stress 11 (18.6%) 1 (2.9%) [0.96,62.5]
17 Loss of consciousness(loc) on HUTT Age < 60 (n=59) Age > 60 (n=35) P value Difference between groups OR(95%CI) LOC (n=55) Amnesia Immediate 33 (56%) 22 (62%) [0.32,1.81] 9 (27%) 13 (59%) [1.23,12] Delayed Amnesia 6 (18%) 10 (45%) [1.10,12.6]
18 HUTT response(n=55) Type 3 Pure Vasodepressor response Type 1 Mixed response Type 2A (Cardio inhibitory) Type 2B (Cardio inhibitory) Amnesia(n=16) No Amnesia(n=39) 12(75%) 23(59%) 1(6%) 3(8%) 2(13%) 7(18%) 1(6%) 6(15%)
19 Discussion Lack of hypotensive awareness increases with age in Vasovagal syncope Amnesia for preceding prodrome and for loss of consciousness is greater in older adults. Risk: Unexplained falls and fractures VVS should be eliminated in those with normal cardiac workup with an otherwise unexplained fall/syncopal event Treatable condition
20 Where to from here?. Why are symptoms and amnesia more prominent in some more than others? Pure haemodynamic/autonomic effect? Correlate Tilt Blood pressure and heart rate response to onset of symptoms and presence of amnesia Independent cerebral component? EEG and TCD studies
Assessment, diagnosis and specialist referral of adults (>16 years) with an episode of transient loss of consciousness (TLoC) or a blackout.
Assessment, diagnosis and specialist referral of adults (>16 years) with an episode of transient loss of consciousness (TLoC) or a blackout. TLoC is common huge variation in management range of clinicians
More informationClinical Glidepath TM Tools Syncope Frail Life expectancy less than five years or significant functional impairment
Robust Elderly greater ALL GROUPS 1 SYMPTOMS a) wth, nausea b) postural symptoms c) chest pain, dyspnea, post-exercise, dizziness, history of heart disease, palpitations, family history (prolonged QT)
More informationIntroduction. What is syncope?
Syncope Introduction What is syncope? Syncope (SING-kuh-pee) is a medical term for fainting. When you faint, your brain is not receiving enough blood and oxygen, so you lose consciousness temporarily.
More informationAutonomic Stress Test
Autonomic Stress Test (The expanded head-up tilt test) Artur Fedorowski Syncope Unit Skåne University Hospital, Malmö, Sweden NordSync 2011, Malmö Disclosure None The expanded head-up tilt test When? Why?
More informationFainting - Syncope. This reference summary explains fainting. It discusses the causes and treatment options for the condition.
Fainting - Syncope Introduction Fainting, also known as syncope, is a temporary loss of consciousness. It is caused by a drop in blood flow to the brain. You may feel dizzy, lightheaded or nauseous before
More informationProfessor Rose Anne Kenny, St James Hospital &Trinity College, Dublin
Syncope Presentation and Investigation in the Acute Setting Professor Rose Anne Kenny, St James Hospital &Trinity College, Dublin Definition- Presentation Syncope is a syndrome consisting of a relatively
More informationConflicts of interest: None
Syncope in Athletes Thomas G. Allison, PhD, MPH Mayo Clinic Rochester, MN USA 13 th Annual Review Course in Clinical Cardiology Zurich 14 April, 2015 CP972908-1 Conflicts of interest: None Syncope: Definition
More informationLiving with Low Blood Pressure
Living with Low Blood Pressure Understand the medical jargon and tips on how to cope with low Blood Pressure (BP) What is low blood pressure? Blood pressure (BP) is measured in millimetres of mercury (mm
More informationtrust clinical guideline
CG23 VERSION 1.0 1/7 Guideline ID CG23 Version 1.0 Title Approved by Transient Loss of Consciousness Clinical Effectiveness Group Date Issued 01/01/2013 Review Date 31/12/2016 Directorate Authorised Staff
More informationCardiac Syncope. spot it, stop it! Syncope is Tranient Loss of Consciousness (T- LOC) due to: transient global cerebral hypoperfusion
Definition Cardiac Syncope spot it, stop it! David Gareth Jones Heart Rhythm Centre Royal Brompton & Harefield NHS Foundation Trust Syncope is Tranient Loss of Consciousness (T- LOC) due to: transient
More informationSyncope 2015: Evaluation and Treatment. Steve Greer, MD FHRS BHHI Primary Care Symposium February 27, 2015
Syncope 2015: Evaluation and Treatment Steve Greer, MD FHRS BHHI Primary Care Symposium February 27, 2015 Financial disclosures Research Support National Heart, Lung, and Blood Institute Boston Scientific
More informationTILT TESTING INFORMATION AND PROTOCOLS
TILT TESTING INFORMATION AND PROTOCOLS For technicians and doctors June 2008 Dr Nicola Cooper Consultant in Acute Medicine & Geriatrics TILT TESTING This information has been compiled for technicians and
More informationNeurocardiogenic Syncope
Neurocardiogenic Syncope Christopher Bonnet, M.D. Director, Clinical Electrophysiology Definition of Syncope Abrupt and transient loss of consciousness Loss of postural tone Spontaneous and rapid recovery
More informationSetting up a Blackout Service
Setting up a Blackout Service Jayne Mudd, Nurse Consultant, Cardiac Rhythm Management James Cook University Hospital, Middlesbrough South Tees NHS Foundation Trust NECVN: Population of approximately 2.8
More informationSyncope in Children and Adolescents: What Are the Peculiar Features?
Syncope in Children and Adolescents: What Are the Peculiar Features? W. WIELING 1,N.VAN DIJK 1, K.S. GANZEBOOM 1,J.P.SAUL 2 Epidemiology Syncope can be defined as a temporary loss of consciousness and
More informationSyncope in the Elderly Assessment and Treatment. Professor Rose Anne Kenny Trinity College Dublin Newcastle University
Syncope in the Elderly Assessment and Treatment Professor Rose Anne Kenny Trinity College Dublin Newcastle University Definition Syncope is a syndrome consisting of a relatively short period of temporary
More information5/1/2015. When should I worry? Presyncope is the feeling that one is about to pass out but remains conscious with a transient loss of postural tone.
When should I worry? Robert Vogt-Lowell, MD, FAAP, FAAC, MAAC Pediatric Cardiologist Pediatrix Cardiology of Miami DEFINITIONS Syncope is a transient loss of consciousness and muscle tone that results
More informationDiagnostic tests for syncope
Diagnostic tests for syncope Working together with individuals, families and medical professionals to offer support and information on syncope and reflex anoxic seizures www.stars.org.uk Registered Charity
More informationApproach to the Patient with Syncope
Syncope Case Study 38-year-old female with recurrent syncope occasionally occurring during emotional stressful times. Her physical examination and 12 lead EKG are normal. Approach to the Patient with Syncope
More informationSyncope in the Primary Care Setting. Ibrahim Hanna MD
Syncope in the Primary Care Setting Ibrahim Hanna MD Definitions SYNCOPE: Abrupt but transient loss of consciousness associated with the absence of postural tone, followed by a rapid and usually complete
More informationNovartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI)
Novartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI) Highlights from Prescribing Information - the link to the full text PI is as follows: http://www.pharma.us.novartis.com/product/pi/pdf/gilenya.pdf
More informationSyncope. Approach Diagnosis and Treatment. Robert Satran MD
Syncope Approach Diagnosis and Treatment Robert Satran MD Transient Loss of Consciousness (TLOC) Transient Loss of Consciousness (TLOC ) Classification Underlying Mechanism Is Transient Global Cerebral
More informationDiana Heiman, MD Associate Professor, Family Medicine Residency Director East Tennessee State University
Diana Heiman, MD Associate Professor, Family Medicine Residency Director East Tennessee State University Objectives Define exercise associated collapse (EAC) and exercise-associated postural hypotension
More informationWyatt Decker, M.D., FACEP Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905
WHICH PATIENTS WITH SYNCOPE NEED TO BE ADMITTED TO THE HOSPITAL Wyatt Decker, M.D., FACEP Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905 Case Unresponsive 82 y.o. male - found
More informationChapter 57 SYNCOPE. Professor R. A. Kenny. Department of Geriatric Medicine and. Institute of Neuroscience. Trinity College. Dublin.
1 Chapter 57 SYNCOPE Professor R. A. Kenny Department of Geriatric Medicine and Institute of Neuroscience Trinity College Dublin Ireland Phone: + 353 1 428 4182 Fax: + 353 1 410 3454 Email: rkenny@tcd.ie
More informationTransient Loss of Consciousness A Clinical Approach
A Clinical Approach Dr. Hany. M. Zaki-eldine, MD Ass Prof Neurology and Interventional Neurology Ain Shams Univ Member of the World Federation of Therapeutic and Interventional Neuroradiology Syncope Epilepsy
More informationGuidelines on Management (Diagnosis and Treatment) of Syncope Update 2004 q Executive Summary
European Heart Journal (2004) 25, 2054 2072 ESC Guidelines Guidelines on Management (Diagnosis and Treatment) of Syncope Update 2004 q Executive Summary The Task Force on Syncope, European Society of Cardiology
More informationWhat Medical Emergencies Should a Dental Office be Prepared to Handle?
What Medical Emergencies Should a Dental Office be Prepared to Handle? Gary Cuttrell, DDS, JD, University of NM Division of Dental Services Santiago Macias, MD, First Choice Community Healthcare Dentists
More informationGuidelines on management (diagnosis and treatment) of syncope*
European Heart Journal (2001) 22, 1256 1306 doi:10.1053/euhj.2001.2739, available online at http://www.idealibrary.com on Task Force Report Guidelines on management (diagnosis and treatment) of syncope*
More informationWhat Can I Do about Atrial Fibrillation (AF)?
Additional Device Information 9529 Reveal XT Insertable Cardiac Monitor The Reveal XT Insertable Cardiac Monitor is an implantable patientactivated and automatically activated monitoring system that records
More informationPATIENT REGISTRATION
Orthopedic & Sports Therapy Center PATIENT REGISTRATION NAME DATE OF BIRTH SSN# FIRST MI LAST PHONE INFO: HOME BEST WAY TO CONFIRM APPOINTMENTS WORK CALL TEXT EMAIL MOBILE (TEXT) MOBILE CARRIER EMAIL ADDRESS
More informationDrugs and pacemakers for vasovagal, carotid sinus and situational syncope (Review)
Drugs and pacemakers for vasovagal, carotid sinus and situational syncope (Review) Romme JJCM, Reitsma JB, Black CN, Colman N, Scholten RJPM, Wieling W, Van Dijk N This is a reprint of a Cochrane review,
More informationArrhythmia from a GP Perspective. Dr Jonathan Shribman GPSI Cardiology Northamptonshire
Arrhythmia from a GP Perspective Dr Jonathan Shribman GPSI Cardiology Northamptonshire Arrhythmia from a GP Perspective Common presentation in General Practice Associated with considerable morbidity But
More informationDefining and classifying syncope. Clinical Autonomic Research 2004;14 (Suppl 1): 4 8
Defining and classifying syncope Roland D. Thijs, 1 Wouter Wieling, 2 Horacio Kaufmann, 3 J. Gert van Dijk 1 Clinical Autonomic Research 2004;14 (Suppl 1): 4 8 [1] Department of Neurology and Clinical
More informationwww.irishheart.ie LONG QT SYNDROME SUPPORT GROUP IRELAND
www.irishheart.ie LONG QT SYNDROME SUPPORT GROUP IRELAND Long QT Syndrome Support Group This is a voluntary group of people, all of whom have families with Long QT syndrome (LQTS). It was set up in association
More informationLow Blood Pressure. This reference summary explains low blood pressure and how it can be prevented and controlled.
Low Blood Pressure Introduction Low blood pressure, or hypotension, is when your blood pressure reading is 90/60 or lower. Some people have low blood pressure all of the time. In other people, blood pressure
More informationCoronary Artery Disease leading cause of morbidity & mortality in industrialised nations.
INTRODUCTION Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations. Although decrease in cardiovascular mortality still major cause of morbidity & burden of disease.
More informationClinical Review. An approach to the evaluation and management of syncope in adults. Steve W Parry, Maw Pin Tan
Clinical Review For the full versions of these articles see bmj.com An approach to the evaluation and management of syncope in adults Steve W Parry, Maw Pin Tan Falls and Syncope Service, Royal Victoria
More informationAnaphylaxis Recognition and Out of Hospital Management
Western Canada Immunization Forum Anaphylaxis Recognition and Out of Hospital Management Joy Loewen, Manager Province-wide Immunization Program March 6, 2014 1 Presenter Disclosure Joy Loewen Relationships
More informationSyncope. enough to include disorders such as epileptic seizures and concussion. January 14-15, 2011 SCA Conference 1
Syncope and Atypical Seizures Ravi Mandapati, M.D., FACC.; FHRS Director, Specialized Program for Arrhythmias in Congenital Heart Disease UCLA Cardiac Arrhythmia Center David Geffen School of Medicine
More informationIs it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine
Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics Yen Tibayan, M.D. Division of Cardiovascular Medicine Case Presentation 69 y.o. woman calls 911 with the complaint of
More informationWorkers Compensation Form
Workers Compensation Form Patient Name: Job Title: Employer: What is your current work status? Working full duty Off work due to injury, since: Working light or modified duty Other: Does your job require
More informationEmergency Scenario. Chest Pain
Emergency Scenario Chest Pain This emergency scenario reviews chest pain in a primary care patient, and is set up for roleplay and case review with your staff. 1) The person facilitating scenarios can
More informationGuide to Claims against General Practitioners (GPs)
Patients often build up a relationship of trust with their GP over a number of years. It can be devastating when a GP fails in his or her duty to a patient. Our medical negligence solicitors understand
More informationTilt asistolico VASIS 2B Pro
Tilt asistolico VASIS 2B Pro Francesco Arabia U.O. Cardiologia UTIC Emodinamica e Cardiologia Interventistica Presidio Ospedaliero A. Pugliese Catanzaro Vasis 1992 Vasis 2000 Tipo 2A : 'la frequenza
More informationGuidelines on Management (Diagnosis and Treatment) of Syncope e Update 2004 *
Europace (2004) 6, 467e537 ESC GUIDELINES Guidelines on Management (Diagnosis and Treatment) of Syncope e Update 2004 * The Task Force on Syncope, European Society of Cardiology ** Task Force members:
More informationManagement of Diabetes
Management of Diabetes Blood Glucose Monitoring MANAGEMENT OF DIABETES Once someone is told they have diabetes, they are usually asked to check their blood glucose at home with a home blood glucose meter
More informationCardiac Rehabilitation
Cardiac Rehabilitation Exercise and Education Program Always thinking. Always caring. Cardiac Rehabilitation Dear Patient: Cardiac rehabilitation is an important part of your recovery. Our progressive
More informationSt. Luke s MS Center New Patient Questionnaire. Name: Date: Birth date: Right or Left handed? Who is your Primary Doctor?
St. Luke s MS Center New Patient Questionnaire Name: Date: Birth date: Right or Left handed? Who is your Primary Doctor? Who referred you to the MS Center? List any other doctors you see: Reason you have
More informationPATIENT INFORMATION INSURANCE INFORMATION
PATIENT INFORMATION NAME DATE ADDRESS CITY ST ZIP PHONE(H) (C) (W) DATE OF BIRTH EMAIL AGE SEX: M F SS#(optional) EMPLOYER OCCUPATION ARE YOU CURRENTLY: MARRIED PARTNERED DIVORCED WIDOWED SINGLE SPOUSE/PARTNER
More informationBecoming an Advanced Nurse Practitioner in Ireland. Emily Bury, ANP Candidate (Acute Medicine)
Becoming an Advanced Nurse Practitioner in Ireland Emily Bury, ANP Candidate (Acute Medicine) Background 2010 June 2013 NAMP National recommends Acute Medicine the development Programme of ANP posts with
More informationNEW PATIENT CLINICAL INFORMATION FORM. Booth Gardner Parkinson s Care & Movement Disorders Center Evergreen Neuroscience Institute
NEW PATIENT CLINICAL INFORMATION FORM Booth Gardner Parkinson s Care & Movement Disorders Center Evergreen Neuroscience Institute Date: Name: Referring Doctor: How did you hear about us? NWPF Your Physician:
More informationSyncopal Attacks Imitating Epileptic Seizures
Syncopal Attacks Imitating Epileptic Seizures 2 Syncopes are among the most common non-epileptic attacks misdiagnosed as 1, 25-39 epileptic seizures, including GTCSs. A syncope is de fi ned as a paroxysmal
More informationACCIDENT HISTORY QUESTIONNAIRE
ACCIDENT HISTORY QUESTIONNAIRE PATIENT INFORMATION Name Date Address City State Zip Code DOB Age SS# Marital Status Sex Male Female How did you hear about the office? Home Phone Work Phone Employer Occupation
More informationGuidelines for the diagnosis and management of syncope (version 2009)
European Heart Journal doi:10.1093/eurheartj/ehp298 ESC GUIDELINES Guidelines for the diagnosis and management of syncope (version 2009) The Task Force for the Diagnosis and Management of Syncope of the
More informationSouthwestern Foot & Ankle Associates, P.C. 3880 Parkwood Blvd, Suite 602 Frisco, TX 75034 Phone: 972-335-9071 Fax: 972-335-8920 Dr. Thomas H.
Phone: 972-335-9071 Fax: 972-335-8920 Date: Home Phone ( ) Patient Information (Please Print) Email: Name: SS/Patient ID # Last Name First Name Middle Initial Address Cell Phone ( ) City State Zip Sex
More informationNational Hospital for Neurology and Neurosurgery. Migraine associated dizziness Department of Neuro-otology
National Hospital for Neurology and Neurosurgery Migraine associated dizziness Department of Neuro-otology If you would like this document in another language or format or if you require the services of
More informationSYNCOPE a symptom, not a diagnosis
SYNCOPE a symptom, not a diagnosis Dr Jaycen Cruickshank Ballarat Emergency Education Grampians Emergency Medicine Training Hub Syncope Learning objectives Learning objectives To name the common and important
More informationCLINICAL MEDICINE. Syncope. Pushpa Yadav*, Arvind Sethi**, AK Agarwal***, Arun Jain*
CLINICAL MEDICINE JIACM 2003; 4(24): 286-91 Syncope Pushpa Yadav*, Arvind Sethi**, AK Agarwal***, Arun Jain* Syncope is a term applicable to sudden and transient loss of consciousness alongwith postural
More informationBusiness Loan Insurance Plan Critical Illness Claim - Policy 57903
Business Loan Insurance Plan Critical Illness Claim - Policy 57903 RBC use only Before submitting a critical illness claim: Complete and sign the Claimant s Statement for your critical illness. Please
More information50 years of CRM Device Therapy Past, Present and Future. Richard Sutton Professor of Cardiology Imperial College, London, UK
50 years of CRM Device Therapy Past, Present and Future Richard Sutton Professor of Cardiology Imperial College, London, UK The Past First implant 1958 Sweden Dual Chamber pacing (VAT) 1962 US Transvenous
More informationEssentials of Clinical Neurology: Neurology History and Examination 8-1 LA Weisberg, C Garcia, R Strub www.psychneuro.tulane.
Essentials of Clinical Neurology: Neurology History and Examination 81 CHAPTER 8 Episodic Loss of Consciousness DEFINITION AND INCIDENCE Syncope is the cause of 3% of emergency room visits and 6% of general
More informationRehabilitation Medicine Clinic. New Patient Questionnaire
Rehabilitation Medicine Clinic (Please complete this 5-page form and bring to your appointment.) Date Appt. Date Age Date of Birth Name Male Female Hand dominance: R L Home Address Home Phone ( ) Work
More informationAcute Coronary Syndrome. What Every Healthcare Professional Needs To Know
Acute Coronary Syndrome What Every Healthcare Professional Needs To Know Background of ACS Acute Coronary Syndrome (ACS) is an umbrella term used to cover a spectrum of clinical conditions that are caused
More informationNeurogenic Syncope. Dharmen Shah MD Piedmont Healthcare Neurology and Sleep Medicine
Neurogenic Syncope Dharmen Shah MD Piedmont Healthcare Neurology and Sleep Medicine Neurogenic Syncope Anatomy of Autonomic Nervous System Physiology of sympathetic and parasympathetic system Etiology
More informationIn general, causes of syncope are addressed as entities
414 Multiple Causes of Syncope Original Article Prevalence and Clinical Outcomes of Patients With Multiple Potential Causes of Syncope LIN Y. CHEN, MD; BERNARD J. GERSH, MB, CHB, DPHIL; DAVID O. HODGE,
More informationAtrial Fibrillation (AF) Explained
James Paget University Hospitals NHS Foundation Trust Atrial Fibrillation (AF) Explained Patient Information Contents What are the symptoms of atrial fibrillation (AF)? 3 Normal heartbeat 4 How common
More informationHow To Get A Medical Checkup From A Doctor
Welcome to Schoonman Chiropractic. We look forward to providing you the best possible care. Please fill out the following information for our records: Name: Name of Parent (If Minor): Address: Phone Number:
More informationAcquired, Drug-Induced Long QT Syndrome
Acquired, Drug-Induced Long QT Syndrome A Guide for Patients and Health Care Providers Sudden Arrhythmia Death Syndromes (SADS) Foundation 508 E. South Temple, Suite 202 Salt Lake City, Utah 84102 800-STOP
More informationCardiac Rehabilitation. Exercise and Education Program
Cardiac Rehabilitation Exercise and Education Program Cardiac Rehabilitation Dear Patient: Cardiac rehabilitation is an important part of your recovery. Our progressive cardiac rehabilitation program
More informationCBT/OTEP 243 Aspirin Administration for ACS
Seattle-King County EMS Seattle-King County Emergency Medical Services Division Public Health - Seattle/King County 401 5th Avenue, Suite 1200 Seattle, WA 98104 (206) 296-4693 February 2009 CBT/OTEP 243
More informationAtrial Fibrillation: Drugs, Ablation, or Benign Neglect. Robert Kennedy, MD October 10, 2015
Atrial Fibrillation: Drugs, Ablation, or Benign Neglect Robert Kennedy, MD October 10, 2015 Definitions 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary.
More informationRevised 10-4-10 Bethel Park s Sports Concussion and Closed Head Injury Protocol and Procedures for Student-Athletes
Bethel Park s Sports Concussion and Closed Head Injury Protocol and Procedures for Student-Athletes If the Certified Athletic Trainer of Bethel Park School District has a concern that a student-athlete
More informationThe Global Relief Association for Crises & Emergencies G.R.A.C.E. COUNSELING INTAKE FORM
The Global Relief Association for Crises & Emergencies G.R.A.C.E. COUNSELING INTAKE FORM Personal Information Date: Name: Phone #: Cell #: May we leave a message on these numbers?: Best time to reach me
More informationLOEWENBERG SCHOOL OF NURSING LOEWENBERG SCHOOL OF NURSING HEALTH EXAMINATION FORM (FORM 003)
SECTION I: To be completed by STUDENT: Name: DOB: Address: Phone (H): Phone (C): Health History: Please complete the following information: Recent weight loss or gain Fatigue, fever, sweats Difficulty
More informationAdvanced Rehab Solutions 609 Morris Avenue Springfield, NJ 07081
Advanced Rehab Solutions 609 Morris Avenue Springfield, NJ 07081 PLEASE COMPLETE ALL OF THE INFORMATION. REFERRED BY: LAST NAME MIDDLE FIRST STREET ADDRESS CITY STATE ZIP CODE HOME PHONE ( ) - WORK ( )
More informationNon-epileptic seizures
Non-epileptic seizures a short guide for patients and families Information for patients Department of Neurology Royal Hallamshire Hospital What are non-epileptic seizures? In a seizure people lose control
More informationTilt Table Testing for Assessing Syncope
263 ACC EXPERT CONSENSUS DOCUMENT Tilt Table Testing for Assessing Syncope DAVID G. BENDITT, MD, FACC, CHAIR DAVID W. FERGUSON, MD, FACC BLAIR P. GRUBB, MD, FACC WISHWA N. KAPOOR, MD JOHN KUGLER, MD, FACC
More informationNEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only)
PAGE 1 NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only) 1. What is the main problem that you are having? (If additional space is required, please use the back of this
More informationCelexa Zombie Effects Sleepiness
Celexa Zombie Effects Sleepiness celexa zombie effects tmj feeling like a zombie on celexa reviews celexa zombie effects beginning feel like a zombie on celexa makes me celexa qtc certification celexa
More informationType 2 Diabetes Type 2 Diabetes
Pennington Nutrition Series Healthier lives through education in nutrition and preventive medicine Pub No. 33 Type 2 is the most common form of diabetes. In this form, the body does not produce enough
More informationParkinson s Disease (PD)
Parkinson s Disease (PD) Parkinson s disease (PD) is a movement disorder that worsens over time. About 1 in 100 people older than 60 has Parkinson s. The exact cause of PD is still not known, but research
More informationPotential Causes of Sudden Cardiac Arrest in Children
Potential Causes of Sudden Cardiac Arrest in Children Project S.A.V.E. When sudden death occurs in children, adolescents and younger adults, heart abnormalities are likely causes. These conditions are
More informationPostural tachycardia syndrome following human papillomavirus vaccination
European Journal of Neurology 2014, 21: 135 139 doi:10.1111/ene.12272 Postural tachycardia syndrome following human papillomavirus vaccination S. Blitshteyn Department of Neurology, State University of
More informationPersonal Injury Intake Form
Personal Injury Intake Form Patient Information: Name Home Phone Address Work Phone Cell Phone Date of Birth Social Security # Sex Male Female Height Weight lbs Occupation Marital Status Employer No of
More informationSyncope Unit Project A prospective systematic guideline-based evaluation and treatment of patients referred to the Syncope Units of general hospitals
AIAC Associazione Italiana Aritmologia e Cardiostimolazione Syncope Unit Project Syncope Unit Project A prospective systematic guideline-based evaluation and treatment of patients referred to the Syncope
More informationEmergency Medical Transport Billing
Emergency Medical Transport Billing Program Information For Older Adults Fairfax County Fire and Rescue Department Emergency Medical Transport Billing Program 4100 Chain Bridge Road Fairfax, Virginia 22030
More informationEvaluation of Syncope
Evaluation of Syncope W. Richard Bukata, MD Clinical Professor Emergency Medicine at the Los Angeles County / University of Southern Calilomia Medical Center; Medical Director of the Emergency Department
More informationAdverse Events Following Immunisation (AEFI) Noel McCarthy Thames Valley Public Health England Centre and Everybody
Adverse Events Following Immunisation (AEFI) Noel McCarthy Thames Valley Public Health England Centre and Everybody A fifteen year old with diabetes came for his MMR and was referred by the school nurse
More informationDonor Adverse Events
Donor Adverse Events Common terminology Frequency Risk factors Hold still, Mrs. Brown, while I draw your blood Mindy Goldman, MD Canadian Blood Services IHN Seminar, Paris March 11, 2016 Outline Donor
More informationTelemedicine Service Measurably Reduces the Costs of Healthcare
Telemedicine Service Measurably Reduces the Costs of Healthcare T. Harju 1, L. Toivonen 2 1 RemoteA Ltd, Lars Sonckin kaari 10-16, FI-02600 Espoo, tuomas.harju@remotea.com 2 Heart Counsel Ltd, Komentajankatu
More informationEXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA. a) pharmacy records reflecting the dispensing of Bextra and/or Celebrex to the Class Member; or
EXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA 1. PRODUCT IDENTIFICATION DOCUMENTATION In order to be eligible for compensation under the Settlement Agreement, each Claimant must provide evidence of the Class
More informationBreast Cancer. Breast Cancer Page 1
Breast Cancer Summary Breast cancers which are detected early are curable by local treatments. The initial surgery will give the most information about the cancer; such as size or whether the glands (or
More informationN E B R A S K A JAIL BULLETIN NUMBER 102 OCTOBER 1993
N E B R A S K A JAIL BULLETIN NUMBER 102 OCTOBER 1993 The Jail Bulletin is a monthly feature of the Crime Commission Update. The Bulletin may be used as a supplement to your jail in-service training program
More informationAlcohol Overuse and Abuse
Alcohol Overuse and Abuse ACLI Medical Section CME Meeting February 23, 2015 Daniel Z. Lieberman, MD Professor and Vice Chair Department of Psychiatry George Washington University Alcohol OVERVIEW Definitions
More informationBenign Pituitary Tumor
PATIENT EDUCATION patienteducation.osumc.edu The pituitary gland is a small, pea-sized endocrine gland in the center of the brain. Also known as the master gland, the pituitary gland helps control the
More informationAdvanced Cardiovascular Life Support Case Scenarios
Advanced Cardiovascular Life Support Case Scenarios ACLS Respiratory Arrest Case Out-of-Hospital Scenario You are a paramedic and respond to the scene of a possible cardiac arrest. A young man lies motionless
More informationEmory Eye Center New Patient Questionnaire
Patient Name: Date: Current Address: Current Phone: Date of Birth: Primary Care Physician: Referring Physician: (First & Last Name) (First & Last Name) Pharmacy Name: Phone #: ( ) Please answer all questions
More informationTHE MANAGEMENT OF CONCUSSION IN AUSTRALIAN FOOTBALL
THE MANAGEMENT OF CONCUSSION IN AUSTRALIAN FOOTBALL AFL Research board AFL MEDICAL OFFICERS' ASSOCIATION THE MANAGEMENT OF CONCUSSION IN AUSTRALIAN FOOTBALL This document has been published by the AFL
More informationMEDICATION GUIDE ACTOPLUS MET (ak-tō-plus-met) (pioglitazone hydrochloride and metformin hydrochloride) tablets
MEDICATION GUIDE (ak-tō-plus-met) (pioglitazone hydrochloride and metformin hydrochloride) tablets Read this Medication Guide carefully before you start taking and each time you get a refill. There may
More information